Background The clinical features of COVID-19 are varied, ranging from asymptomatic state to acute respiratory distress syndrome and multi organ dysfunction. The extreme rise in inflammatory cytokines resulting in significant morbidity and mortality, especially in presence of co-morbid illness such as chronic liver disease. Methodology: This was a case-control study, carried among the target population at Quarantine departments at Aswan governorate. Patients were subjected to complete history taking, physical examination and investigations including full labs, pelviabdominal ultrasound and chest computerized tomography (CT). Confirmation of COVID-19 infection done by PCR from nasopharyngeal swabs.  Patients divided into two groups according to presence or absence of chronic hepatitis C virus (HCV) infection. Results: There was statistically significant correlation between severity of COVID-19 infection and presence of chronic HCV infection (P-value < 0.001). Severe and critically-ill COVID-19 cases are more among the HCV infected patients. There was a highly significant difference in Child-Pugh score before and after COVID-19 infection (P-value < 0.001).Conclusion HCV infection is associated with more severe disease and higher mortality in patients co-infected with COVID-19 virus. The severity of liver impairment was associated with poor clinical outcomes in COVID-19 patients.